4 - Epidemiology, Indices, and Statistics Flashcards
Describe the gingival index, plaque index, and retention index
Who are they by?
Gingival index 0 - No bleeding 1 - Color change 2 - BOP 3 - Spontaneous BOP
Plaque index 0 - no plaque 1 - plaque w/ probe sweep 2 - visible plaque 3 - gross plaque
Retention index 0 - no roughness 1 - supragingival roughness/calculus 2 - subgingival 3 - gross roughness
LOE
What are the Ramfjord teeth?
3,9,12,19,25,28
What is another plaque index?
Turesky-Gilman-Glickman Modification of Quigley Hein
0 - no plaque 1 - flecks at margin 2 - <1mm band 3 - >1mm band, <1/3 4 - 1/3-2/3 band 5 - >2/3 band
What is an example of a bleeding index?
Interdental bleeding index by Caton
Stim-U-Dent from facial, depress papilla 1-2mm 4X and assess bleeding within 15 seconds
What was the first disease index to include CAL?
Periodontal Disease Index by Ramfjord
Ramfjord teeth on B + M 0 - no inflammation 1 - mild spots of inflammation 2- circumferential inflammation 3 - severe gingivitis 4 - CAL <3mm 5 - CAL 4-6mm 6 - CAL >6mm
What are two indices of treatment needs?
CPI - Community Periodontal Index
-WHO probe, highest score per sextant, 1M/2M/8/24
0 - healthy 1 - BOP 3 - Calculus + BOP 4 - PD 4-5mm 5 - PD 6mm+
PSR 0 - healthy 1 - BOP 2 - BOP + calculus 3 - PD 3.5-5.5mm 4 - PD >6mm
What is the effect of partial recording protocols? What is most effective
Susin - underestimate CAL prevalence. Full mouth MB/B/Dl w/ smallest bias
Is the NHANES accurate with partial recording protocols?
Eke
NO - underestimation. 9% was what they thought when it was actually 22%
What is the prevalence of ChP in the US? What populations are most affected?
NHANES 2009-2014 w/ FMPE
42.2%. Severe ChP 7.8%
Older, Mexican, smokers, diabetics, under FPL, lack of dental care
What states are most/least affected?
Prevalence
NM - highest
Utah - lowest
Severity
Louisiana - Highest
New Hampshire - Lowest
Are caries and ChP related?
Mattila - NHANES
ChP w/ caries 33%
Healthy w/ caries 23%
Caries w/ severe ChP 31%
No caries w/ severe ChP 16%
Tend to accumulate in the same subjects
What should I expect in a population of treated and untreated periodontitis?
Loe 1978
• According to the Loe study of Norwegians and Sri Lankans, for a population with access to dental care a rate of 0.08-0.10mm loss of attachment per year and localized to the buccal can be expected. For a population with no dental care, a rate of 0.3mm/year, often found interproximally can be expected. • Disease progression did not significantly increase with age. This study demonstrates the efficacy of oral hygiene at minimizing attachment loss
If I have prior CAL, will I automatically have future CAL?
Lindhe - NO
In a longitudinal study of Swedish and American patients, the progression of disease was infrequent and sites with prior CAL should not be regarded as a prognostic factor for further disease progression
Does everyone have CAL at the same rate?
Loe
No, in Sri Lankans over 15 years there were 3 groups
Rapid - 8%
Moderate - 81%
No - 11%
What are long term consequences for lack of dental treatment?
Ramseier 2017
After a 40 year f/u with the Sri Lankans, the average tooth loss/subject was 13.1
Smoking, calculus, and plaque are associated with disease initiation and progression
What are some predictive factors for ChP?
Schatzle - In Norwegians, smokers 2X and calculus 5X are associated with disease progression
Paulander - In 50 year old patients, the # of remaining teeth, existing RBL, and education levels had a significant influence on the progression of ChP
EKe - NHANES 65+, males, AA, and smokers
What is the cause of early LOA?
Heitz-Mayfield
Norwegians, recession is the primary cause of early loss of attachment. Especially on the buccal of posterior teeth
IP pocketing >3mm is more common for age >50 years old
How common is recession?
Loe
Norwegians - >60% of 20 year olds on buccal surface
Sri Lankan - 100% 40 year old. 70% buccal, 50% lingual, and 40% IP
Albander - NHANES. 58% w/ >1mm of recession and 22% teeth/person with 1mm of recession
MAX 1M and mandibular central incisors
How common is BOP? Calculus?
Albander NHANES
BOP 50%, increase in extent w/ increasing age
Calculus 92%. 50% of teeth/person
What is a risk factor?
A characteristic that increases the probability that an event will occur
What is a prognostic factor
A measurable characteristic at the time of diagnosis that gives info on the likely clinical outcome
What is a risk ratio
The probability that an individual of the exposed group will develop the disease relative to the probability that an individual of the unexposed group will develop disease
What is an odds ratio
The odds that an outcome will occur with the exposure compared to the probability that the outcome will occur without exposure
